Myelodysplastic Syndromes and Incident Cardiovascular Disease: A Nationwide, Real-world Cohort Study
Bibliographic record
Abstract
BACKGROUND: The association between myelodysplastic syndromes (MDS) and cardiovascular disease (CVD) has been suggested in prior studies, but evidence in the general population remains limited. In the present study, we evaluate the association between MDS and incident CVD in a large nationwide Japanese cohort. METHODS: We analyzed 1,137,351 individuals without prior CVD from the DeSC database in Japan between April 2014 and August 2023. MDS was identified using International Classification of Diseases-10th revision codes before the baseline health check-up. Using multivariable Cox regression, we assessed the association of MDS with ischemic heart disease (IHD), stroke, heart failure (HF), atrial fibrillation (AF), and their composite. RESULTS: Among 1,137,351 individuals (median age 63 [49-68] years, 43.8% men), 550 (0.05%) had MDS. During a mean follow-up of 3.5 ± 2.3 years, 121,265 individuals experienced CVD events. MDS was significantly associated with the composite CVD outcome (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.57-2.20), as well as with each individual outcome: IHD (HR 1.62, 95% CI 1.18-2.23), stroke (HR 1.82, 95% CI 1.32-2.50), HF (HR 1.81, 95% CI 1.47-2.23), and AF (HR 2.26, 95% CI 1.52-3.38). This finding remained unchanged across age, sex, and anemia status. CONCLUSIONS: MDS was independently associated with incident CVD, including IHD, stroke, HF, and AF. MDS should be recognized as an independent cardiovascular risk factor in both clinical practice and public health strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".